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We aimed to systematically review the Berlin questionnaire as a screening tool for obstructive sleep apnea. We systematically searched PubMed, Embase, and Scopus databases, reviewed articles reporting the Berlin questionnaire's diagnostic utility as measured against type-1 polysomnography, and performed meta-analyses where possible. Thirty five eligible articles showed that the Berlin questionnaire's diagnostic utility varied by study population, definition of hypopnea used, and apnea-hypopnea index threshold used. It had good sensitivity and specificity for detecting clinically relevant obstructive sleep apnea as well as any obstructive sleep apnea in the sleep clinic population. Despite limited evidence, it showed modest to high sensitivity for detecting clinically relevant obstructive sleep apnea or any obstructive sleep apnea in other clinical and general population subgroups. Its specificity was relatively low. Possible reasons for variability in reported diagnostic utility of the Berlin questionnaire are multifaceted. We conclude that the Berlin questionnaire is useful as a clinical screening test and epidemiological tool in the sleep clinic population. Despite limited evidence, it likely has potential clinical and research utility in other populations. Adopting more consistent methodological definitions and focussing more on the general population and specific clinical populations to determine its usefulness as a clinical or epidemiological screening tool are recommended. [ABSTRACT FROM AUTHOR]

Background: Many calorie-rich dietary components contribute to obesity. However, the contribution of confectionery to obesity in children and adolescents has not been well established. Objective: In this systematic review and meta-analysis, we hypothesized that higher total, chocolate, and nonchocolate confectionery consumption would be associated with higher odds of overweight, obesity, and other obesity-related outcomes [body mass index (BMI), BMI z score, body composition, waist circumference, and percentage body fat] in children and adolescents. Design: We searched Scopus, PubMed, and reference lists of pertinent reviews, supplemented by expert contact, for randomized controlled trials (RCTs) and observational studies published between 1990 and 31 March 2015, and we conducted separate meta-analyses for categorical and continuous ORs and for total, chocolate, and nonchocolate confectioneries with the use of a random-effects model. Results: A total of 19 studies were included in the systematic review, and the cross-sectional results of 11 studies (~177,260 participants) were included in the meta-analysis. In the meta-analysis, which examined the combined outcome of overweight and obesity, the odds of overweight or obesity were 18% lower (OR: 0.82; 95% CI: 0.69, 0.97) for subjects in the highest category of consumption than for a reference category of consumption. Thus, a 1-time/wk or a 1-U increase in consumption was associated with a 13% (OR: 0.87; 95% CI: 0.85, 0.88) decrease in the odds of overweight or obesity. Associations were similarly inverse for chocolate and nonchocolate confectioneries. In the longitudinal studies and the RCT included in the review, no associations were observed between confectionery consumption and overweight, obesity, or obesity-related outcomes. Conclusions: Instead of overweight and obese children and adolescents having higher confectionery intakes, this review shows the reverse effect. This result might reflect a true inverse association, reverse causality, or differential underreporting in heavier individuals. Interventions may need to focus on dietary elements other than confectionery to tackle obesity. [ABSTRACT FROM AUTHOR]

Abstract: Background: Bone mineral density (BMD) is lower in amenorrheic athletes (AA) compared with eumenorrheic athletes (EA). Decreased energy availability and altered levels of appetite regulating hormones (ghrelin and leptin) in AA contribute to hypogonadism, an important cause of low BMD. The role of other nutritionally regulated hormones such as peptide YY (PYY) and adiponectin in mediating gonadal status and bone metabolism remains to be determined. Objectives: Our objective was to determine whether PYY and adiponectin are higher in AA compared with EA and contribute to hypogonadism and impaired bone metabolism in AA. Methods: We determined PYY and adiponectin in 16 AA, 15 EA and 16 non-athletic controls 12–18 years old, and other nutritionally dependent hormones including ghrelin, leptin and IGF-1. We also measured testosterone, estradiol, PINP and NTX (markers of bone formation and resorption) and BMD. Results: PYY was higher in AA than EA (111±52 vs. 61±29 pg/ml, p <0.05), whereas adiponectin did not differ between groups. Although activity scores did not differ, BMI was lower in AA than EA and a larger proportion (62.5% vs. 6.7%) reported disordered eating, indicating lower energy availability. PYY and adiponectin were independent predictors of testosterone in a regression model (p =0.01 and 0.04), but did not predict estradiol. PYY, but not adiponectin, was an independent and negative predictor of PINP (p =0.002) and lumbar bone mineral apparent density Z-scores (p =0.045) in this model. Conclusion: High PYY levels (but not adiponectin) differentiate AA from EA, and may be an important factor contributing to low bone density in athletes. [Copyright &y& Elsevier]

The process of screening newborns for congenital disorders is important for the early detection and treatment of multiple medical conditions. Congenital hypothyroidism and congenital adrenal hyperplasia are two endocrine disorders evaluated on all newborn screens. Early treatment of these conditions can prevent intellectual disability and life-threatening adrenal crisis. False positive and false negative results may occur for both conditions and it is important to understand common factors that can alter screening results. In addition, screening protocols vary among states and awareness of testing protocols may assist with interpretation of abnormal results. Improvement in assay sensitivity and adjustments to reference ranges have altered the detection of both conditions. All abnormal newborn screen results need to be further evaluated with confirmatory testing to establish a diagnosis. [ABSTRACT FROM AUTHOR]

Objectives The adverse mental health effects of caring have been studied, frequently in carers of people with dementia. Less is known about the mental health of carers of people with other conditions. This study compared depression and burden in older carers looking after people with a variety of conditions. Design, methods and measures Over 200 older carers interested in participating in the Improving Mood through Physical Activity in Carers and Care-recipient Trial were included in this cross-sectional study, using the Geriatric Depression Scale (GDS) and Zarit Burden Inventory (ZBI). Results Overall there were 43% of carers who were depressed and a quarter of them reported moderate-to-severe burden. Carers of people with physical conditions had the highest levels of depression and burden. Patient diagnosis, hours spent caring, and burden were associated with depression, while hours spent caring and carer depression were associated with burden. These factors contributed approximately 25–30% of the variance of depression and burden, respectively. Conclusions The diagnosis of the patient was a factor associated with depression, and older carers of people with physical conditions were at the highest risk. It is important for clinicians to assess the mental health of all carers, regardless of the patient diagnosis. [ABSTRACT FROM AUTHOR]

Previous research demonstrates that physical activity has psychological benefits for people of all ages. However, it is unclear whether people caring for a frail or ill relative would derive similar psychological benefits, considering the potentially stressful caregiver role. This article reviews the current literature describing the effect of physical activity interventions on the psychological status of caregivers. A search from January 1975 to December 2012 identified five intervention studies investigating physical activity and psychological status in caregivers. These focused on female Caucasian caregivers who were older than 60 years. The physical activity interventions improved stress, depression and burden in caregivers, but small sample sizes, short-term follow up and varying results limited the generalizability of the findings. There were few trials investigating male caregivers, and most care-recipients were people with dementia. Studies with caregivers of different ages and gender, with a range of physical activity interventions, are needed to clarify whether physical activity has psychological benefits for caregivers. [ABSTRACT FROM AUTHOR]